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. 1985 Jun;44(6):384–389. doi: 10.1136/ard.44.6.384

Studies on the interaction of rheumatoid factor with monosodium urate crystals and case report of coexistent tophaceous gout and rheumatoid arthritis.

T P Gordon, M J Ahern, C Reid, P J Roberts-Thomson
PMCID: PMC1001657  PMID: 4015200

Abstract

Gout and classical rheumatoid arthritis rarely coexist. We report a patient with strong evidence for both these diseases. Possible reasons for the negative correlation between these diseases are summarised. One hypothesis suggests inhibition of surface activity of monosodium urate crystals (MSU) by binding of rheumatoid factor (RF). This was studied with a purified monoclonal rheumatoid factor (mRF) with specificity for IgG. The mRF bound preferentially to MSU coated with IgG in contrast with the IgM control. Inhibition of the neutrophil chemiluminescence (CL) response to IgG-coated MSU was observed at concentrations of mRF that had no effect on the CL response to uncoated crystals. Neutrophil activation was not altered by coating crystals with an IgM control at the same concentration. These data suggest that RF may bind to antigenic determinants on exposed Fc of adsorbed IgG and block the interaction of crystal-bound IgG with Fc receptors. Although crystal coating by RF may modify the expression of gouty arthritis, it is unlikely to be the sole explanation for the dissociation between gout and RA.

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Selected References

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  1. Abramson S., Hoffstein S. T., Weissmann G. Superoxide anion generation by human neutrophils exposed to monosodium urate. Arthritis Rheum. 1982 Feb;25(2):174–180. doi: 10.1002/art.1780250210. [DOI] [PubMed] [Google Scholar]
  2. Agudelo C. A., Turner R. A., Panetti M., Pisko E. Does hyperuricemia protect from rheumatoid inflammation? A clinical study. Arthritis Rheum. 1984 Apr;27(4):443–448. doi: 10.1002/art.1780270412. [DOI] [PubMed] [Google Scholar]
  3. Allen R. C., Stjernholm R. L., Steele R. H. Evidence for the generation of an electronic excitation state(s) in human polymorphonuclear leukocytes and its participation in bactericidal activity. Biochem Biophys Res Commun. 1972 May 26;47(4):679–684. doi: 10.1016/0006-291x(72)90545-1. [DOI] [PubMed] [Google Scholar]
  4. Ames B. N., Cathcart R., Schwiers E., Hochstein P. Uric acid provides an antioxidant defense in humans against oxidant- and radical-caused aging and cancer: a hypothesis. Proc Natl Acad Sci U S A. 1981 Nov;78(11):6858–6862. doi: 10.1073/pnas.78.11.6858. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Bardin T., Varghese Cherian P., Schumacher H. R. Immunoglobulins on the surface of monosodium urate crystals: an immunoelectron microscopic study. J Rheumatol. 1984 Jun;11(3):339–341. [PubMed] [Google Scholar]
  6. Denko C. W., Whitehouse M. W. Experimental inflammation induced by naturally occurring microcrystalline calcium salts. J Rheumatol. 1976 Mar;3(1):54–62. [PubMed] [Google Scholar]
  7. Gale R., Bertouch J. V., Gordon T. P., Bradley J., Roberts-Thomson P. J. Neutrophil activation by immune complexes and the role of rheumatoid factor. Ann Rheum Dis. 1984 Feb;43(1):34–39. doi: 10.1136/ard.43.1.34. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Goldenberg D. L., Cohen A. S. Synovial membrane histopathology in the differential diagnosis of rheumatoid arthritis, gout, pseudogout, systemic lupus erythematosus, infectious arthritis and degenerative joint disease. Medicine (Baltimore) 1978 May;57(3):239–252. doi: 10.1097/00005792-197805000-00004. [DOI] [PubMed] [Google Scholar]
  9. Heusser C., Boesman M., Nordin J. H., Isliker H. Effect of chemical and enzymatic radioiodination on in vitro human Clq activities. J Immunol. 1973 Mar;110(3):820–828. [PubMed] [Google Scholar]
  10. Jessee E. F., Toone E., Owen D. S., Irby R. Coexistent rheumatoid arthritis and chronic tophaceous gout. Arthritis Rheum. 1980 Feb;23(2):244–247. doi: 10.1002/art.1780230217. [DOI] [PubMed] [Google Scholar]
  11. Kozin F., Ginsberg M. H., Skosey J. L. Polymorphonuclear leukocyte responses to monosodium urate crystals: modification by adsorbed serum proteins. J Rheumatol. 1979 Sep-Oct;6(5):519–526. [PubMed] [Google Scholar]
  12. Kozin F., McCarty D. J. Molecular orientation of immunoglobulin G adsorbed to microcrystalline monosodium urate monohydrate. J Lab Clin Med. 1980 Jan;95(1):49–58. [PubMed] [Google Scholar]
  13. Kozin F., McCarty D. J. Protein binding to monosodium urate monohydrate, calcium pyrophosphate dihydrate, and silicon dioxide crystals. I. Physical characteristics. J Lab Clin Med. 1977 Jun;89(6):1314–1325. [PubMed] [Google Scholar]
  14. Kozin F., McCarty D. J. Rheumatoid factors in the serum of gouty patients. Arthritis Rheum. 1977 Nov-Dec;20(8):1559–1560. doi: 10.1002/art.1780200823. [DOI] [PubMed] [Google Scholar]
  15. Lussier A., de Medicis R., Marquis L., Menard H. Inhibition of adjuvant-induced arthritis in the hyperuricemic rat. Agents Actions. 1978 Oct;8(5):536–542. doi: 10.1007/BF02111442. [DOI] [PubMed] [Google Scholar]
  16. MCCARTY D. J., Jr THE PENDULUM OF PROGRESS IN GOUT: FROM CRYSTALS TO HYPERURICEMIA AND BACK. Arthritis Rheum. 1964 Oct;7:534–541. doi: 10.1002/art.1780070509. [DOI] [PubMed] [Google Scholar]
  18. Phelps P., McCarty D. J., Jr Crystal-induced inflammation in canine joints. II. Importance of polymorphonuclear leukocytes. J Exp Med. 1966 Jul 1;124(1):115–126. doi: 10.1084/jem.124.1.115. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Rappoport A. S., Sosman J. L., Weissman B. N. Lesions resembling gout in patients with rheumatoid arthritis. AJR Am J Roentgenol. 1976 Jan;126(1):41–45. doi: 10.2214/ajr.126.1.41. [DOI] [PubMed] [Google Scholar]
  20. Rizzoli A. J., Trujeque L., Bankhurst A. D. The coexistence of gout and rheumatoid arthritis: case reports and a review of the literature. J Rheumatol. 1980 May-Jun;7(3):316–324. [PubMed] [Google Scholar]
  21. Roberts-Thomson P. J. A reappraisal of the monoclonal rheumatoid factor test for circulating immune complexes: a comparison of two monoclonal rheumatoid factor reagents. Clin Exp Immunol. 1982 Apr;48(1):52–60. [PMC free article] [PubMed] [Google Scholar]
  22. Schwartzberg M., Lieberman D. H., Gupta V. P., Ehrlich G. E. Rheumatoid arthritis and chronic gouty arthropathy. JAMA. 1978 Dec 8;240(24):2658–2659. [PubMed] [Google Scholar]
  23. Scott J. T. Gout. Ann Rheum Dis. 1983 Aug;42 (Suppl 1):16–18. doi: 10.1136/ard.42.suppl_1.16. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Talbott J. H., Altman R. D., Yü T. F. Gouty arthritis masquerading as rheumatoid arthritis or vice versa. Semin Arthritis Rheum. 1978 Nov;8(2):77–114. doi: 10.1016/0049-0172(78)90014-8. [DOI] [PubMed] [Google Scholar]
  25. Terkeltaub R., Curtiss L. K., Tenner A. J., Ginsberg M. H. Lipoproteins containing apoprotein B are a major regulator of neutrophil responses to monosodium urate crystals. J Clin Invest. 1984 Jun;73(6):1719–1730. doi: 10.1172/JCI111380. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Trentham E. D., Masi A. T. Chronic synovitis in gout simulating rheumatoid arthritis. Demonstration of bilateral popliteal cysts and wrist synovial corrugation. JAMA. 1976 Mar 29;235(13):1358–1360. [PubMed] [Google Scholar]
  27. Turner R. A., Counts G. B., Treadway W. J., Holt D. A., Agudelo C. A. Rheumatoid factor and monosodium urate crystal-neutrophil interactions in gouty inflammation. Inflammation. 1981 Dec;5(4):353–361. doi: 10.1007/BF00911099. [DOI] [PubMed] [Google Scholar]
  28. Turner R. A., Pisko E. J., Agudelo C. A., Counts G. B., Foster S. L., Treadway W. J. Uric acid effects on in vitro models of rheumatoid inflammatory and autoimmune processes. Ann Rheum Dis. 1983 Jun;42(3):338–342. doi: 10.1136/ard.42.3.338. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Turner R. A., Schumacher R., Myers A. R. Phagocytic function of polymorphonuclear leukocytes in rheumatic diseases. J Clin Invest. 1973 Jul;52(7):1632–1635. doi: 10.1172/JCI107342. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Wallace D. J., Klinenberg J. R., Morham D., Berlanstein B., Biren P. C., Callis G. Coexistent gout and rheumatoid arthritis. Case report and literature review. Arthritis Rheum. 1979 Jan;22(1):81–86. doi: 10.1002/art.1780220113. [DOI] [PubMed] [Google Scholar]

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